1,721,004 research outputs found
Corrigendum to “Epidemiology and predictors of relapse in giant cell arteritis: A systematic review and meta-analysis” [Joint Bone Spine 2023;90 :105494]
No full textEpidemiology and predictors of relapse in giant cell arteritis: A systematic review and meta-analysis
No full textOBJECTIVES: The aim of this study was to estimate the timing of relapse, the prevalence of multiple relapses and the predictors of relapse in patients with giant cell arteritis (GCA). METHODS: PubMed, Embase and Cochrane databases were searched from inception till November, 30 2021. Outcome measures include cumulative relapse rate (CRR) of first relapse at year 1, 2, and 5 after treatment initiation, CRR of second and third relapse and predictors of relapse. RESULTS: Thirty studies (2595 patients) were included for timing of relapse, 16 studies (1947 patients) for prevalence of multiple relapses and 40 studies (4213 patients) for predictors of relapse. One-year, 2-year and 5-year CRRs were 32% [95% confidence interval (CI) 22-43%], 44% [95% CI 31-59%], and 47% [95% CI 27-67%], respectively. The duration of scheduled glucocorticoid therapy was negatively associated with the 1-year CRR (P=0.03). CRR of second and third relapse were 30% [95% CI 21-40] and 17% [95% CI 8-33%], respectively. Female sex (OR 1.43) and large vessel involvement (OR 2.04) were predictors of relapse. CONCLUSION: Relapse occurred in almost half of GCA patients mainly during the first two years after diagnosis. One in three patients had multiple relapses. The optimal glucocorticoid tapering schedule, which seeks a balance between the lowest relapse risk and the shortest glucocorticoid duration, needs to be determined in future studies. Longer scheduled glucocorticoid therapy or early introduction of glucocorticoid-sparing agents may be warranted in female patients and patients with large vessel involvement.status: Publishe
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Association Between Vascular FDG Uptake at Diagnosis and Evolution in Aortic Dimensions in Giant Cell Arteritis: A Prospective Study
No full textScientific Abstracts 335 Conclusion: Patients with atypical PMR could represent an early form of the classic PMR. Atypical PMR used to have a shorter evolution of symptoms, have predominantly hip/pelvic girdle affection. US of the shoulders and hips may have an added value for stratifying PMR patients and differentiating atypical PMR from other musculoskeletal conditions. Background: Temporal Artery Biopsy (TAB) is costly, invasive and has a false negative rate as high as 60% [1]. Temporal Artery Ultrasound (TAUS) and Superficial Temporal Artery (STA) MR-Angiography (MRA) have shown widely dispa-rate results in studies to date [1-3]. ACR GCA Classification Criteria are often misused in clinical practice as diagnostic criteria. Objectives: In this prospective study, we compare TAUS, TAB and STA MRA to physician diagnosis of GCA at 6 months. Methods: We performed a prospective study of all new referrals (n=124) to our Rapid Access GCA clinic over 18 months. US of all 6 branches of the STA and both axillary arteries was performed using a GE P9 device. Abnormalities considered indicative of vasculitis in the STA included the halo sign (Figure 1) and non-com-pressible arteries with a thickened intima-media complex [4]. In the axillary arteries , a halo sign and an intima-media thickness of >1.0mm was considered positive. A subset of our patients were referred for TAB and/or MRA. MRAs were scored 0-4 based on mural wall thickness and signal intensity of mural peri-adventitial contrast enhancement [5]. We compared results to a clinical diagnosis of GCA at 6 months, verified by 2 rheumatologists. We performed Chi-Square tests with ROC analyses to determine the performance of each diagnostic modality. Figure 1. Transverse view of STA, demonstrating a halo sign, as indicated by the anechoic region (green arrow) surrounding the inner Doppler (red arrow) signal
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Association Between Vascular FDG Uptake at Diagnosis and Evolution in Aortic Dimensions in Giant Cell Arteritis: A Prospective Study
No full textScientific Abstracts 335 Conclusion: Patients with atypical PMR could represent an early form of the classic PMR. Atypical PMR used to have a shorter evolution of symptoms, have predominantly hip/pelvic girdle affection. US of the shoulders and hips may have an added value for stratifying PMR patients and differentiating atypical PMR from other musculoskeletal conditions. Background: Temporal Artery Biopsy (TAB) is costly, invasive and has a false negative rate as high as 60% [1]. Temporal Artery Ultrasound (TAUS) and Superficial Temporal Artery (STA) MR-Angiography (MRA) have shown widely dispa-rate results in studies to date [1-3]. ACR GCA Classification Criteria are often misused in clinical practice as diagnostic criteria. Objectives: In this prospective study, we compare TAUS, TAB and STA MRA to physician diagnosis of GCA at 6 months. Methods: We performed a prospective study of all new referrals (n=124) to our Rapid Access GCA clinic over 18 months. US of all 6 branches of the STA and both axillary arteries was performed using a GE P9 device. Abnormalities considered indicative of vasculitis in the STA included the halo sign (Figure 1) and non-com-pressible arteries with a thickened intima-media complex [4]. In the axillary arteries , a halo sign and an intima-media thickness of >1.0mm was considered positive. A subset of our patients were referred for TAB and/or MRA. MRAs were scored 0-4 based on mural wall thickness and signal intensity of mural peri-adventitial contrast enhancement [5]. We compared results to a clinical diagnosis of GCA at 6 months, verified by 2 rheumatologists. We performed Chi-Square tests with ROC analyses to determine the performance of each diagnostic modality. Figure 1. Transverse view of STA, demonstrating a halo sign, as indicated by the anechoic region (green arrow) surrounding the inner Doppler (red arrow) signal
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Medication adherence in patients with chronic non-malignant pain: an exploratory study.
No full textChronic pain of non-malignant origin is a long-lasting condition, often requiring long-term medication intake. The aim of this doctoral research was to study the prevalence and determinants of medication non-adherence, both under- and overuse, and to investigate the impact of medication non-adherence on pain intensity, interference of pain in daily activities, the perceived physical and mental health status and patient satisfaction with pain treatment.Medication adherence in chronic non-malignant pain populations is not well studied. Our systematic review indicated that non-adherence with pain medication varies between 8% and 53%. Yet, the limited number of studies are characterized by numerous methodological problems, i.e. 1)the lack of a conceptual and operational definition of adherence, 2)the absence of a clear distinction between medication underuse, overuse or abuse, 3)the use of less reliable measurement methods, 4) a rather small sample sizes and 5) no differentiation in type of pain medication being assessed. Due to these methodological problems, it is difficult to make firm conclusions on the prevalence and determinants of medication non-adherence in patients with chronic non malignant pain. Knowledge on determinants is needed to define risk profiles and to guide successful interventions. Finally, only a few studies investigated the impact of medication non-adherence on clinical outcome in this population, which again suffered from methodological problems.First, we investigated the prevalence of medication non-adherence. Half of our patients deviated from the prescribed pharmacological treatment. More specifically, 48% percent of the patients included in a single center cross-sectional study (chapter 3) and 62% of a multi-center sample (chapter 4) did not perfectly follow the prescribed medication regimen of the pain center. Our study added to the existing literature, by examining both underuse and overuse of pain medication within the same patient sample. Medication underuse in patients with chronic non-malignant pain ranges between 32% (single center study; chapter 3) and 40% (multicenter study; chapter 4). Fourteen percent of the patients, both in our single center (chapter 3) and multicenter study (chapter 4), were using more medication than prescribed. Our second aim was to study the potential determinants of both medication underuse and overuse non-adherence in patients with chronic non-malignant pain, using all dimensions described in the World Health Organization framework. This WHO framework describes adherence to long-term therapies as a multi-dimensional phenomenon, influenced by the interplay of five interacting factors: socio-economic factors, therapy related factors, patient related factors, condition related factors and health care team / system related factors. In a multicenter, cross-sectional study among 265 chronic pain patients, we found that only 38% of the patients were perfectly adherent. Based on multivariable analyses, underuse was significantly associated with more prescribed analgesics, self medication, lower pain intensity, and lack of information. Overuse of medication was associated with more prescribed analgesics and current smoking. Our results show that the set of determinants of non-adherence, proposed by the WHO is suitable to study drivers of underuse, but that the framework is less suitable to study determinants of medication overuse. Thus, in future research and clinical practice, differentiating between these two types of medication non-adherence is warranted, because a different set of variables influence underuse and overuse.Finally, we selected five outcome parameters, that are considered to be important subjective endpoints for patients with chronic pain. We studied prospectively the evolution of pain intensity, the interference of pain on daily activities, physical and mental functioning and patient satisfaction with their pain treatment over a period of nine months and investigated whether medication non-adherence had a significant impact on this evolution. In our study, we could not find a significant impact of medication non-adherence on the evolution of these selected outcome parameters. However, patient satisfaction with pain treatment improved over time, especially in adherent patients.While more research is needed to refine the assessment methods of adherence, the risk profile of underusers and overusers, and the drivers of these medication taking behaviors, we recommend health care professionals paying more attention to medication underuse and overuse. Only with good mutual communication on medication taking behavior, the efficacy of pain treatment can be properly evaluated and improved.status: Publishe
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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